Temporal Bone Imaging

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  • TEMPORAL BONE IMAGINGSasan Dabiri, M.D.Assistant Professor

    Department of ORL-HNS

    Amir Alam Hospital - TUMS

  • IMAGING MODALITIES

    CT

    Bone

    Soft

    Without Contrast

    With Contrast

    MR

    Spin Echo

    Single SE

    T1 , T1+

    T2 ,

    Proton Density

    Multiple SE

    FSE , TSE

    Inversion Recovery

    STIR , FLAIR

    MR

    Gradient Echo

    Diffusion Weighted

    EPI

    Non-EPI

    Single-shot

    Multi-shot

    Balanced GE (FIESTA)

    Steady State GE (FISP)

    Hybrid Echo

  • Anatomy is the Basis of Surgery,

    it informs the head,

    guides the hand, and

    familiarizes the heart to

    a kind of necessary inhumanity.William Hunter

    1718 - 1783

    //upload.wikimedia.org/wikipedia/commons/e/e0/William_Hunter_(anatomist).jpg//upload.wikimedia.org/wikipedia/commons/e/e0/William_Hunter_(anatomist).jpg

  • www.boundless.com

  • TEMPORAL COMPARTMENTS

    External Auditory Canal

    Middle Ear and Mastoid

    Inner Ear Cochlea

    Vestibule

    Semicircular Canals

    Internal Auditory Canal

    Petrous Apex

    Cerebello-Pontine Angle

    Facial Nerve

  • CORONAL PLANE RIGHT EAR

  • CORONAL PLANE RIGHT EAR

  • CORONAL PLANE RIGHT EAR

  • CORONAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • AXIAL PLANE RIGHT EAR

  • EAC Cavity

    Cochlea

    SCCs

    IACVestibule

    AXIAL PLANE RIGHT EAR

  • Normal Imaging

  • NORMAL FINDINGS

    Pseudo-fractures

    Extrinsic Fissures &

    Sutures

  • NORMAL FINDINGS

    Pseudo-fractures

    Intrinsic Fissures

    Petrotymanic or glaserian(chorda)

    Petrosquamosal (koerner)

    Tympanosquamosal (align to ant. of EAC)

    Tympanomastoid (align to post. of EAC)

  • Abnormal Findings

  • DIFFERENTIAL DIAGNOSES

    Common External Auditory Canal Abnormalities

    Congenital

    Atresia

    Inflammatory Infection

    Cholesteatoma

    Skull base Osteomyelitis

    Neoplasm

    Benign : Osteoma , Exostosis

    Malignant : SCC

  • DIFFERENTIAL DIAGNOSES

    Common Middle Ear & Mastoid Abnormalities

    Congenital

    Vascular (carotid, jugular)

    Inflammatory Infection

    Cholesteatoma

    Mastoiditis

    Colesterol Granuloma

    Neoplasm

    Benign : Glomus

    Malignant : Metastasis

  • DIFFERENTIAL DIAGNOSES

    Common Inner Ear Abnormalities

    Congenital

    Large Vestibular Aqueduct

    Semicircular canal Dehiscence

    Otosclerosis

    Inflammatory Infection

    Labyrinthitis

    Neoplasm

    Schwannoma

    Endolymphatic Sac Tumor

  • DIFFERENTIAL DIAGNOSES

    Common Petrous Apex Abnormalities

    Pseudo-lesions

    Congenital

    Cephalocele

    Inflammatory Infection

    Petrous Apicitis

    Cholesterol Granuloma

    Neoplasm

    Chondrosarcoma

    Metastasis

  • DIFFERENTIAL DIAGNOSES

    Common Facial Nerve Abnormalities

    Congenital

    Venous Malformation

    Inflammatory Infection

    Bells palsy (herpetic neuralgia)

    Neoplasm

    Schwannoma

    Perineural Tumor spread

  • REFERENCES

    o https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-textbook/the-skeletal-system-7/the-skull-79/cranial-bones-459-8856/ (last accessed: Jul 2015)

    o http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/axialpages/Overview.html(last accessed: Jul 2015)

    o http://teachmeanatomy.info/head/osteology/temporal-bone/ (last accessed: Jul 2015)

    o Imaging of the Head & Neck, Mafee

    o Head & Neck Imaging, Som

    o Imaging of the Temporal Bone, Radiolodic clinics

    https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-textbook/the-skeletal-system-7/the-skull-79/cranial-bones-459-8856/http://www.med.wayne.edu/diagRadiology/Anatomy_Modules/axialpages/Overview.htmlhttp://teachmeanatomy.info/head/osteology/temporal-bone/

  • THANKS FOR YOUR ATTENTION